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Anatomic Basis of Colonoscopy

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Advanced Colonoscopy and Endoluminal Surgery

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Abstract

Colonoscopy is an integral modality utilized by physician and surgeons and offers diagnostic and therapeutic capabilities. A knowledge of the anatomic landmarks and impressions, as well as internal cues and mural changes, is expected in understanding normal physiological and pathologic changes. A fundamental understanding of this anatomy and its variations as well as understanding how to navigate and reduce colonoscopic looping permits the surgeon to proceed in a safe manner and perform a safe, efficient, and painless colonoscopy.

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References

  1. Wolff WI, Shinya H, Geffen A, Ozaktay SZ. Colonofiberoscopy. A new and valuable diagnostic modality. Am J Surg. 1972;123(2):180–4.

    Article  CAS  PubMed  Google Scholar 

  2. Wolff WI, Shinya H. Colonofiberoscopy. JAMA. 1971;217(11):1509–12.

    Article  CAS  PubMed  Google Scholar 

  3. Wolff WL, Shinya H. Colonofiberoscopy: diagnostic modality and therapeutic application. Bull Soc Int Chir. 1971;30(5):525–9.

    CAS  PubMed  Google Scholar 

  4. Colon cancer screening (USPSTF recommendation). U.S. preventive services task force. J Am Geriatr Soc. 2000;48(3):333–5.

    Google Scholar 

  5. Rex DK, Helbig CC. High yields of small and flat adenomas with high-definition colonoscopes using either white light or narrow band imaging. Gastroenterology. 2007;133(1):42–7.

    Article  PubMed  Google Scholar 

  6. Nielsen C. Six screening tests for adults: what’s recommended? What’s controversial? Cleve Clin J Med. 2014;81(11):652–5.

    Article  PubMed  Google Scholar 

  7. Henley SJ, King JB, German RR, Richardson LC, Plescia M, Centers for Disease Control and Prevention, et al. Surveillance of screening-detected cancers (colon and rectum, breast, and cervix)—United States, 2004-2006. MMWR Surveill Summ. 2010;59(9):1–25.

    PubMed  Google Scholar 

  8. Hafner M. Conventional colonoscopy: technique, indications, limits. Eur J Radiol. 2007;61(3):409–14.

    Article  PubMed  Google Scholar 

  9. Eickhoff A, Pickhardt PJ, Hartmann D, Riemann JF. Colon anatomy based on CT colonography and fluoroscopy: impact on looping, straightening and ancillary manoeuvres in colonoscopy. Dig Liver Dis. 2010;42(4):291–6.

    Article  PubMed  Google Scholar 

  10. Rex DK, Chen SC, Overhiser AJ. Colonoscopy technique in consecutive patients referred for prior incomplete colonoscopy. Clin Gastroenterol Hepatol. 2007;5(7):879–83.

    Article  PubMed  Google Scholar 

  11. Rex DK, Goodwine BW. Method of colonoscopy in 42 consecutive patients presenting after prior incomplete colonoscopy. Am J Gastroenterol. 2002;97(5):1148–51.

    Article  PubMed  Google Scholar 

  12. Saunders BP, Fukumoto M, Halligan S, Jobling C, Moussa ME, Bartram CI, et al. Why is colonoscopy more difficult in women? Gastrointest Endosc. 1996;43(2 Pt 1):124–6.

    Article  CAS  PubMed  Google Scholar 

  13. Saunders BP, Phillips RK, Williams CB. Intraoperative measurement of colonic anatomy and attachments with relevance to colonoscopy. Br J Surg. 1995;82(11):1491–3.

    Article  CAS  PubMed  Google Scholar 

  14. Shah SG, Thomas-Gibson S, Lockett M, Brooker JC, Thapar CJ, Grace I, et al. Effect of real-time magnetic endoscope imaging on the teaching and acquisition of colonoscopy skills: results from a single trainee. Endoscopy. 2003;35(5):421–5.

    Article  CAS  PubMed  Google Scholar 

  15. Shah SG, Saunders BP, Brooker JC, Williams CB. Magnetic imaging of colonoscopy: an audit of looping, accuracy and ancillary maneuvers. Gastrointest Endosc. 2000;52(1):1–8.

    Article  CAS  PubMed  Google Scholar 

  16. Saunders BP, Masaki T, Sawada T, Halligan S, Phillips RK, Muto T, et al. A peroperative comparison of Western and Oriental colonic anatomy and mesenteric attachments. Int J Colorectal Dis. 1995;10(4):216–21.

    Article  CAS  PubMed  Google Scholar 

  17. Prechel JA, Sedlack RE, Harreld FA, Sederquest MM. Looping and abdominal pressure: a visual guide to a successful colonoscopy. Gastroenterol Nurs. 2015;38(4):289–94. Quiz 95–6

    Article  PubMed  Google Scholar 

  18. Hansel SL, Prechel JA, Horn B, Crowell MD, DiBaise JK. Observational study of the frequency of use and perceived usefulness of ancillary manoeuvres to facilitate colonoscopy completion. Dig Liver Dis. 2009;41(11):812–6.

    Article  CAS  PubMed  Google Scholar 

  19. Roberts-Thomson IC, Teo E. Colonoscopy: art or science? J Gastroenterol Hepatol. 2009;24(2):180–4.

    Article  PubMed  Google Scholar 

  20. Shi X, Shan Y, Yu E, Fu C, Meng R, Zhang W, et al. Lower rate of colonoscopic perforation: 110,785 patients of colonoscopy performed by colorectal surgeons in a large teaching hospital in China. Surg Endosc. 2014;28(8):2309–16.

    Article  PubMed  Google Scholar 

  21. Adeyemo A, Bannazadeh M, Riggs T, Shellnut J, Barkel D, Wasvary H. Does sedation type affect colonoscopy perforation rates? Dis Colon Rectum. 2014;57(1):110–4.

    Article  PubMed  Google Scholar 

  22. Okholm C, Hadikhadem T, Andersen LT, Donatsky AM, Vilmann P, Achiam MP. No increased risk of perforation during colonoscopy in patients undergoing nurse administered propofol sedation. Scand J Gastroenterol. 2013;48(11):1333–8.

    Article  PubMed  Google Scholar 

  23. Magdeburg R, Sold M, Post S, Kaehler G. Differences in the endoscopic closure of colonic perforation due to diagnostic or therapeutic colonoscopy. Scand J Gastroenterol. 2013;48(7):862–7.

    Article  PubMed  Google Scholar 

  24. Won DY, Lee IK, Lee YS, Cheung DY, Choi SB, Jung H, et al. The indications for nonsurgical management in patients with colorectal perforation after colonoscopy. Am Surg. 2012;78(5):550–4.

    PubMed  Google Scholar 

  25. Navaneethan U, Kochhar G, Phull H, Venkatesh PG, Remzi FH, Kiran RP, et al. Severe disease on endoscopy and steroid use increase the risk for bowel perforation during colonoscopy in inflammatory bowel disease patients. J Crohns Colitis. 2012;6(4):470–5.

    Article  PubMed  Google Scholar 

  26. Navaneethan U, Parasa S, Venkatesh PG, Shen B. Prevalence and risk factors for colonic perforation during colonoscopy in hospitalized end-stage renal disease patients on hemodialysis. Int J Colorectal Dis. 2012;27(6):811–6.

    Article  PubMed  Google Scholar 

  27. Hagel AF, Boxberger F, Dauth W, Kessler HP, Neurath MF, Raithel M. Colonoscopy-associated perforation: a 7-year survey of in-hospital frequency, treatment and outcome in a German university hospital. Colorectal Dis. 2012;14(9):1121–5.

    Article  CAS  PubMed  Google Scholar 

  28. Whitlock EP, Lin JS, Liles E, Beil TL, Fu R. Screening for colorectal cancer: a targeted, updated systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2008;149(9):638–58.

    Article  PubMed  Google Scholar 

  29. Chukmaitov A, Bradley CJ, Dahman B, Siangphoe U, Warren JL, Klabunde CN. Association of polypectomy techniques, endoscopist volume, and facility type with colonoscopy complications. Gastrointest Endosc. 2013;77(3):436–46.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Stock C, Ihle P, Sieg A, Schubert I, Hoffmeister M, Brenner H. Adverse events requiring hospitalization within 30 days after outpatient screening and nonscreening colonoscopies. Gastrointest Endosc. 2013;77(3):419–29.

    Article  PubMed  Google Scholar 

  31. Phaosawasdi K, Cooley W, Wheeler J, Rice P. Carbon dioxide-insufflated colonoscopy: an ignored superior technique. Gastrointest Endosc. 1986;32(5):330–3.

    Article  CAS  PubMed  Google Scholar 

  32. Church JM. Warm water irrigation for dealing with spasm during colonoscopy: simple, inexpensive, and effective. Gastrointest Endosc. 2002;56(5):672–4.

    Article  PubMed  Google Scholar 

  33. Bretthauer M, Kalager M, Adami HO, Hoff G. Who is for CO2? Slow adoption of carbon dioxide insufflation in colonoscopy. Ann Intern Med. 2016;165(2):145–6.

    Article  PubMed  Google Scholar 

  34. Memon MA, Memon B, Yunus RM, Khan S. Carbon dioxide versus air insufflation for elective colonoscopy: a meta-analysis and systematic review of randomized controlled trials. Surg Laparosc Endosc Percutan Tech. 2016;26(2):102–16.

    Article  PubMed  Google Scholar 

  35. Xu X, Zhu H, Chen D, Fan L, Lu T, Shen Q, et al. Carbon dioxide insufflation or warm-water infusion for unsedated colonoscopy: a randomized controlled trial in patients with chronic constipation in China. Saudi J Gastroenterol. 2016;22(1):18–24.

    Article  PubMed  Google Scholar 

  36. Chen SW, Hui CK, Chang JJ, Lee TS, Chan SC, Chien CH, et al. Carbon dioxide insufflation during colonoscopy can significantly decrease post-interventional abdominal discomfort in deeply sedated patients: a prospective, randomized, double-blinded, controlled trial. J Gastroenterol Hepatol. 2016;31(4):808–13.

    Article  PubMed  Google Scholar 

  37. Ishaq S, Disney BR, Shetty S, Kurup AK. Water exchange versus carbon dioxide insufflation in unsedated colonoscopy: less is more. Endoscopy. 2015;47(10):958.

    Article  PubMed  Google Scholar 

  38. Lynch I, Hayes A, Buffum MD, Conners EE. Insufflation using carbon dioxide versus room air during colonoscopy: comparison of patient comfort, recovery time, and nursing resources. Gastroenterol Nurs. 2015;38(3):211–7.

    Article  PubMed  Google Scholar 

  39. Anderson JC, Pohl H. Water and carbon dioxide—turning back the clock to unsedated colonoscopy. Endoscopy. 2015;47(3):186–7.

    Article  PubMed  Google Scholar 

  40. Garborg K, Kaminski MF, Lindenburger W, Wiig H, Hasund A, Wronska E, et al. Water exchange versus carbon dioxide insufflation in unsedated colonoscopy: a multicenter randomized controlled trial. Endoscopy. 2015;47(3):192–9.

    PubMed  Google Scholar 

  41. Sajid MS, Caswell J, Bhatti MI, Sains P, Baig MK, Miles WF. Carbon dioxide insufflation vs conventional air insufflation for colonoscopy: a systematic review and meta-analysis of published randomized controlled trials. Colorectal Dis. 2015;17(2):111–23.

    Article  CAS  PubMed  Google Scholar 

  42. Chen YJ, Lee J, Puryear M, Wong RK, Lake JM, Maydonovitch CL, et al. A randomized controlled study comparing room air with carbon dioxide for abdominal pain, distention, and recovery time in patients undergoing colonoscopy. Gastroenterol Nurs. 2014;37(4):273–8.

    Article  PubMed  Google Scholar 

  43. Sanaka MR. Warm water irrigation is a useful technique during colonoscopy. Am J Gastroenterol. 2008;103(10):2655.

    PubMed  Google Scholar 

  44. Brocchi E, Pezzilli R, Tomassetti P, Campana D, Morselli-Labate AM, Corinaldesi R. Warm water or oil-assisted colonoscopy: toward simpler examinations? Am J Gastroenterol. 2008;103(3):581–7.

    Article  PubMed  Google Scholar 

  45. Luo H, Zhang L, Liu X, Leung FW, Liu Z, Wang X, et al. Water exchange enhanced cecal intubation in potentially difficult colonoscopy. Unsedated patients with prior abdominal or pelvic surgery: a prospective, randomized, controlled trial. Gastrointest Endosc. 2013;77(5):767–73.

    Article  PubMed  Google Scholar 

  46. Leung J, Mann S, Siao-Salera R, Ransibrahmanakul K, Lim B, Canete W, et al. A randomized, controlled trial to confirm the beneficial effects of the water method on U.S. veterans undergoing colonoscopy with the option of on-demand sedation. Gastrointest Endosc. 2011;73(1):103–10.

    Article  PubMed  Google Scholar 

  47. Radaelli F, Paggi S, Amato A, Terruzzi V. Warm water infusion versus air insufflation for unsedated colonoscopy: a randomized, controlled trial. Gastrointest Endosc. 2010;72(4):701–9.

    Article  PubMed  Google Scholar 

  48. Leung FW, Amato A, Ell C, Friedland S, Harker JO, Hsieh YH, et al. Water-aided colonoscopy: a systematic review. Gastrointest Endosc. 2012;76(3):657–66.

    Article  PubMed  Google Scholar 

  49. Leung JW, Do LD, Siao-Salera RM, Ngo C, Parikh DA, Mann SK, et al. Retrospective analysis showing the water method increased adenoma detection rate—a hypothesis generating observation. J Interv Gastroenterol. 2011;1(1):3–7.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Kozarek RA, Botoman VA, Patterson DJ. Prospective evaluation of a small caliber upper endoscope for colonoscopy after unsuccessful standard examination. Gastrointest Endosc. 1989;35(4):333–5.

    Article  CAS  PubMed  Google Scholar 

  51. Church JM. Complete colonoscopy: how often? And if not, why not? Am J Gastroenterol. 1994;89(4):556–60.

    CAS  PubMed  Google Scholar 

  52. Mitchell RM, McCallion K, Gardiner KR, Watson RG, Collins JS. Successful colonoscopy; completion rates and reasons for incompletion. Ulster Med J. 2002;71(1):34–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  53. Shah HA, Paszat LF, Saskin R, Stukel TA, Rabeneck L. Factors associated with incomplete colonoscopy: a population-based study. Gastroenterology. 2007;132(7):2297–303.

    Article  PubMed  Google Scholar 

  54. Papanikolaou IS, Karatzas PS, Varytimiadis LT, Tsigaridas A, Galanopoulos M, Viazis N, et al. Effective colonoscopy training techniques: strategies to improve patient outcomes. Adv Med Educ Pract. 2016;7:201–10.

    PubMed  PubMed Central  Google Scholar 

  55. Nivatvongs S. How to teach colonoscopy. Clin Colon Rectal Surg. 2001;14(4):387–92.

    Article  Google Scholar 

  56. Rex DK. Colonoscopic splenic injury warrants more attention. Gastrointest Endosc. 2013;77(6):941–3.

    Article  PubMed  Google Scholar 

  57. Abunnaja S, Panait L, Palesty JA, Macaron S. Laparoscopic splenectomy for traumatic splenic injury after screening colonoscopy. Case Rep Gastroenterol. 2012;6(3):624–8.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Singla S, Keller D, Thirunavukarasu P, Tamandl D, Gupta S, Gaughan J, et al. Splenic injury during colonoscopy—a complication that warrants urgent attention. J Gastrointest Surg. 2012;16(6):1225–34.

    Article  CAS  PubMed  Google Scholar 

  59. Shankar S, Rowe S. Splenic injury after colonoscopy: case report and review of literature. Ochsner J. 2011;11(3):276–81.

    PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Mayo Clinic Florida, Mayo Clinic College of Medicine, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA

    Ron G. Landmann M.D., F.A.C.S., F.A.S.C.R.S.

  2. Department of Colon and Rectal Surgery, Lahey Health and Medical Center, Tufts University Medical Center, Burlington, MA, USA

    Todd D. Francone M.D., M.P.H., F.A.C.S.

Authors
  1. Ron G. Landmann M.D., F.A.C.S., F.A.S.C.R.S.
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  2. Todd D. Francone M.D., M.P.H., F.A.C.S.
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Corresponding author

Correspondence to Ron G. Landmann M.D., F.A.C.S., F.A.S.C.R.S. .

Editor information

Editors and Affiliations

  1. Department of Surgery - Colon and Rectal Surgery, Keck School of Medicine of University of Southern California, Los Angeles, California, USA

    Sang W. Lee

  2. Division of Colon and Rectal Surgery Department of Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA

    Howard M. Ross

  3. Department of Colon and Rectal Surgery Northwell Health, Huntington Hospital Hofstra School of Medicine, Woodbury, New York, USA

    David E. Rivadeneira

  4. Case Western Reserve University School of Medicine, Cleveland, Ohio, USA

    Scott R. Steele

  5. Division of Colorectal Surgery Department of Surgery, Columbia University, New York, New York, USA

    Daniel L. Feingold

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Landmann, R.G., Francone, T.D. (2017). Anatomic Basis of Colonoscopy. In: Lee, S., Ross, H., Rivadeneira, D., Steele, S., Feingold, D. (eds) Advanced Colonoscopy and Endoluminal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-48370-2_2

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  • DOI: https://doi.org/10.1007/978-3-319-48370-2_2

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